肝细胞癌甲胎蛋白表达与肝祖细胞激活状态及患者预后的关系

目的 探讨原发性肝细胞癌组织中甲胎蛋白（AFP）表达与肝祖细胞激活状态的相关性，并进一步观察对预后的影响。方法 回顾性分析92例接受根治性切除术的原发性肝癌患者资料。其中男性76例，女性16例；年龄25~72岁，中位年龄51岁。对手术病理标本进行AFP和细胞角蛋白19（CK19）染色，定量；分析祖细胞的激活状态评分与AFP表达的相关性；采用单因素Kaplan-Meier生存分析，观察AFP的表达对术后生存时间的影响。 结果 肝癌组织AFP高表达组总生存期短于肝癌组织AFP低表达组（P = 0.021）。祖细胞的激活状态评分与血清AFP浓度、肝癌组织AFP表达呈正相关（P = 0.046，P < 0.001）。结论 肝细胞癌甲胎蛋白表达对肝癌预后有不利影响，它与肝脏祖细胞的激活状态有密切相关性。

Association of alpha fetoprotein in hepatocellular carcinoma with activation of hepatic progenitor cells and patient prognosis

Objective To investigate the relationship of alpha fetoprotein (AFP) with activation of hepatic progenitor cells in hepatocellular carcinoma (HCC) and the prognosis of HCC patients. Methods The clinical data of 92 HCC patients who received curative hepatectomy were retrospectively analyzed. The patients included 76 males and 16 females, with a median age of 51 (ranging 25-72) years. Expression of AFP and CK19 protein was immunohistochemically stained and quantified. Kaplan-Meier survival analysis was used to observe the influence of AFP expression on postoperative survival of patients. Cochran-armitage trend test was used to analyse the association of AFP expression with activation of progenitor cells (CK19 staining). Results Patients with high AFP expression had a significantly shorter survival than those with low AFP expression (P=0.021). The activation score of hepatic progenitor cells was positively correlated with serum AFP concentration (P=0.046) and AFP expression in tumor tissues (P<0.001). Conclusion AFP expression in HCC tissue predicts a poor prognosis. AFP is closely associated with activation of hepatic progenitor cells.